SYNOPSIS The prophylactic effect of the tricyclic antidepressant doxepin given chronically in patients with mixed migrainous and tension headache, has been investigated in a double‐blind cross‐over trial. Twenty‐three patients without serious medical, neurological or psychiatric diseases were included. They were given a course of 9 weeks of doxepin 100 mg daily and doxepin placebo each. Between the two courses a placebo period of 2 weeks was interposed. Only 14 patients completed the trial. The results showed no significant difference in number of headache days on doxepin in comparison to placebo, but on doxepin there was a significant reduction in terms of headache indices, and of the consumption of analgesics and ergotamine preparations. Ten of the 14 patients experienced side effects on doxepin (weight increase, drowsiness, dryness of the mouth).

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A prospective study was carried out in 51 patients admitted for abdominal complaints of at least 1 year's duration. Despite previous hospitalization for the same complaints, no certain diagnosis had been established. After systematic diagnostic procedures in the Medical Dept., Rikshospitalet, 33 patients were given a psychosomatic and 18 patients an organic primary diagnosis. The organic diseases were three cases of Crohn's disease, two of cancer, two of duodenal ulcers, one of gastric ulcer, two of gastroduodenitis, five of postresection syndrome, one of lactose intolerance, one of hyperthyroidism, and one of degeneration of the columna. The patients' condition was registered after 1 year of individual treatment. There was a significant decrease in the number of symptoms, in the psychosomatic score of anxiety, depression, and stress, and in days on sick leave and consultation with physicians in connection with the second compared with the first hospitalization for the whole group, for the psychosomatic group, and for the patients with upper gastrointestinal disease. Increased vitality based on muscular testing was also indicated in the same groups of patients. The study suggests that patients with uncharacteristic abdominal disorders may need a thorough examination at least once in the course of their illness; on the one hand, this may help patients with psychosomatic disease to cope better with their problems, and, on the other hand, primary organic lesions may be difficult to diagnose on the grounds of simple screening procedures.

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